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Home My WebLink AboutELMORE #1 BLK 4 LT 5Elmore #1 Block 4 Lot 5 #018-171-40 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program. 4700 South Bragaw SL P.O. Box 198850 Anchorage, AK 99519.8850 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 Onsite Wastewater Disposal System and/or Well Inspection Report Permit Number. SWO10255 PID Number. 018-171-40 Nome: Wastewater System: ❑ New ■ Upgrade GARY HAMMAN Address: BOX 230294 ' ANCHORAGE, AK 99523 ABSORPTION FIELD Phone: No. of Bedrooms: (907) 345-6991 4 O Deep Trench ■ Shallow Trench 0 Bed 0Mound 0Other LEGAL DESCRIPTION WA'g"° 1.2 Toe" owe fan 3.4a-4.0 n cn/so. rt. Lot: Block Subdivision: Depth to PIW ash" eerrr erlynal WM aro.ot depth bwoolh pip= 0.5 5 4 ELMORE #1 2.9 — 3.5 rt n Township: Range: Section: — — — A added same 0'41^°1 Peds %-v w br4ft 100 0.5 — 1.5 R rt Cron) e1M: NU~ of areae: owtance betwwn I— WELL: ❑ New ❑ Upgrade 5 Ml 2 15+ n. CwrrwMion Prhv* A.B.0 : Tobi Caved Ta Total obowl tion one: pipe lnetalot D-3034/F-810/SCH 40 PVC n n500 so. rt Dram. Dratl` Dale oMled: `` $tree wow twat Fetalw:l t-t n e, npAl I 6 E , x 9 Dae bwlzM 7/25-26/2001 EXtSZ Ft.DRP,4, n«°p nW set At Cas"g N"ght Abe" Gree d: TANK CMR M1 SEPARATION DISTANCES ■Septic 0Holding 0S.T.E.P, eI�NT1998D DOther To Septic Abso tlon Uft Holding gc/PrMalo up1Mdvc°OK ANCHORAGE TANK ca`"'0j ti p 1250 From Tank F:d Station lank sewer un.. Well 100'+ 100'+ 1000+ — 25'+ ueaw. STEEL Manbor w� 2 Surface water 100'+ 100'+ 100'+ — — LIFT STATION Lot Ltne 5'+ 10'+ 5'+ — — 9n In Besor� 500 Menrrroctr . ANCHORAGE TANK ORENCO SYSTEMS en r." at 9tr r." a: teen .0w can at: Foundation 5'+ 1o'+ 5'+ — — 41w 17 41' 47' pang Nolo Mode[ Docb wt bwpeelww p by. "O Curtain Drain NONE KNOW 20 OSI! 05 HHF M M.O.A. BENCH MARK Remarks: THE EXISTING DRAINRELD WAS ABANDONED 1ow11on aW oww'" n: COMPLETELY PER U.P.C. SOUTHEAST CORNER OF CONCRETE STEP AT FRONT PORCH A«arwe tlewbon: 100.00 rt ENOSMU tteAL od000 4 o� QF *�' 4 AWWC INC. Inspections performed by r Dates: 1st 7/25/2001 :.... ... ... ........ A� 2nd 7/25-26/01 3rd 7/27/2001QO� e e A. G ess. Department of Health and Human Services approval ��' •. 7953 LT7Date: 8 '7. o� 404°dPror.eda^°oc Reviewed and approved by: (B«. ,z/00) PERUrrNUMBER: ASBUILT DRAWING PARCEL ID NUMBER: SWO - SW010255 018-171-40 10' UnUWx`EASEMENT 1 WI N I I O �I F.D.a:RsOrOM MOUSE I 3 :31 I / BL1— � DBL2 FCO \ / -� + 1 NATRONA AVENUE DATE: 7/31/2001 DRAWN 6Y: ALASKA «'ATER S WASTE NVATER J.L.M. ------ CONSULTANTS, INC.-- 1� - 3G, 6901 DEBARR ROAD. SUTE 29 - ANCHORAGE. AR 99504 - PHONE 907)3372179 - FAX (907).530-3266 PREPARED FOR: PHONE NUMBER: PAGE NUMBER GARY do DIANA HAMMAN (907) 345-6991 1 2 OF 3 LEGA. DESCRIPTION: ELMORE SUBDIVISION #1; LOT 5. BLOCK 4 TYPE OF WORK: AS—BUILT OF SEPTIC SYSTEM UPGRADE. I NEW PRESSURIZED DRANFlELDS 17953 PERMITNUMBER: ASW LT DRAWING PARCEL ID NUMBER: SWO SWO1O255 018-171-40 TOP OF MANHOLE 95.80 TOP OF TANK AT INLET - 90.28 FINAL GRADE 5f2 MI M2 L51 MH 95.23 TOP OF TANK AT /,,—OUTLET - 90.23 EX15TIN6 1250 CAW 5ERX TANK (IN5fA lR? IN 1998) SOUTH TRENCH �F BOTTOM OF 93.84 INVERT OF INLET - RIGINAL GRADE 97.18 FABRIC NW' SIXI !� {.t/Y ON LIFt 5tA11ON IT OF DISTRIBUTION 94.35 (AVERAGE) BOTTOM OF - 93.58 VERT OF BUNG AT OUTLET - 89.58 NORTH TRENCH �F MT 7/31/2001 r. 4 DRAWN BY: PAI.ASKA «'ATER & WASTEWATER J.L.M. CONSULTANTS, INC. I SCALE: N.T.S. 6901 DEBARK ROAD. WTE r9 • ANCHORAGE, AK 99504 • PHONE 907)337-6179 • FAX (907)31!-3266 PREPARED FOR: PHONE NUMBER: PACE NUMBER: GARY & DIANA HAMMAN (907) 345-6991 3 OF 3 LEGAL DESCRIPTION: ELMORE SUBDIVISION #1; LOT 5. BLOCK 4 TYPE OF WORK: PROFILE AS -BUILT OF SEPTIC SYSTEM UPGRADE. 3RICINAL GRADE 97.58 FABRIC IT OF - 94.OBVDISTRIBUTION) i A. new Page 18 of 25 INSUCTION Rr;PORT MUNICIPALITY OF ANCHORAGE - BUILDING SAFETY DIVISION 4700 SOUTII BRACANV STREET, AINCIIORACE, ALASKA 1ASPEC770NS.• Voice: (907) 343-8.100 Fav (907)149-7777 INFORAL477ON.- (907) 343-8111 "IE: EDS ELECTRIC 01-8246 ADDRESS: ] 4200 BUFFALO AT NATRnNA DATE: 7/27/01 rr10N7701: 272-4591 rlro= 02: LOT: 5 BLOCK: 4 SUBD717SION. L11101E 81 _ CObfb AMA AM -LIFT STATION' -- — --- ---- - - TYPE OF u/: 42. #.t: INSPEC770N. Electrical Rough t-. . �No non-compliance observed. [j Du not conceal until re-inspcded. ❑ C.O. approved. [� Corrections essential as explained below. (-j Will rc-examine at next inspection. ❑ C.C.O. approved (comments below). ❑ N MFC (Stormwater) COMIIEMS. Reinspection? ❑ Etc--rrZ�ccs!_ uNi�EtZL-,(��UNt� t ►�oJ�-�t� �.- �tf�l/�.L INSPECTOR: NIIC tI �YL �" \�71C� {� DAT . ❑ I Storm%vnwtreaimtntpl:ut/mec.onsite. ❑ Stormwalertreatment implemented ❑ Sitdoffsite drainage istuut being controlled ❑ lubWl'correct straw bales. Install/correct silt fences. (-� Other best management practices on sittneeded ❑ See attached detailed notesrnstrnctions. ❑ Failure In comply may rend( in fines. ❑ Take action now. ❑ Rein�mctiun will be made on: Report given to: ❑ ReduectRuw. Comrnny _ 071EN CORRF_C770AN ARE MIADF,, PLF.A.SE CALL FOR INSPECHON DO NOTRE.IIOVE 77115 NO77CE. 0140 Permit Number: SWO10255 MUNICIPALITY OFANCHORAGE /i Development Services Department On -Site Water& Wastewater Program (/ 4700 South Bragaw Street %/i7 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial 3 aywl $rA4,.t 1+ 1 A -q Date Issued: Jul 23, 2001 Expiration Date: Jul 23, 2002 Parcel ID: 018-17140 Legal Description: ELMORE #1 BLK 4 LT 5 Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: 004941 NATRONA AVE Owner Name: Gary L. Hamman Lot Size: 23783 SQ. FT. Owner Address: PO Box 230294 Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99523 - This permit is for the construction of: Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date:/Q Date: G r/'0 Municipality of Anchorage ',fi13 . • • Development Services Department \ Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.cl.anchorage.ak.us (907)343.7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 018-171-40 Permit Number Sw0l02SS Property owner(s) GARY & DIANA HAMMAN Day phone 522-6785 Mailing address (1) P.O, BOX 230294. ANCHORAGE AK Mailing address (2) Zip Code 99523 Legal description (Lot, Block & Sub'd.) FIMORF SUBDIVISION #1- LOT 5 BLOCK 4 Legal description (Section, Township & Range) Lot Size a7;>#_749_5 Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 4 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application Is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. ALASKA WATER & WASTEWATER CONSULTANTS INC. -(Signeture-ofproperty-ownert "uthorized-egenty Permit Fees: 00 Date of Payment: Receipt Number: ('a8Y8 Waiver Fees: Date of Payment: Receipt Number: ALASKA WATER & WASTEWATER CONSULTANTS, INC. July 20, 2001 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, Ak 99519-6650 Ref: Septic System Design for Lot 5, Block 4, Elmore Subdivision #1 To whom it may concern: The existing 4 bedroom house is served by a private well and septic system. The existing septic system is composed of a 1250 gallon septic tank which was installed in 1998 and a trench type drainfield. The existing drainfield is encroaching on groundwater and needs to be replaced. Two test holes were excavated in the area of the proposed septic system. The proposed septic system will be designed around the 30 foot radius of test hole #1. We are proposing that a 500 gallon lift station and a dual five foot wide drainfield be installed. Comments regarding the proposed design are summarized as follows: 1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that an application rate of 1.2 gallons/day/ft should be used. 2. TRENCH DESIGN: a. Percolation Rate: 3.1 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/R2 c. Number of Bedrooms: 4 d. Design Flow: 600 gallons per day e. Minimum Absorption Area: 5000 f. Total Depth: 4 feet (max.) g. Effective Depth: 0.5 feet h. Width: 5 feet i. Reduction Factor: N/A j. Minimum Length: 2 x 50 feet (100 feet long total) k Effective absorption area = 500 ft2 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There is a culvert on the east side of Buffalo Street that diverts drainage across Buffalo Street and down the north side of Natrona Ave. There was no running water noted in the culvert during any of our site visits. Given the topography near the inlet to the culvert, it is anticipated that there will be standing water at the inlet periodically throughout the year. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography of this property is a 0 to 10 percent slope running from approximately northeast to southwest; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. M.S. NOTE: Attached is a site plan drawing, a design drawing, two soils log, a topographical drawing, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com SHOSHONI AVE. -------------- ELMORE SUBDMSION /1 ELMORE SUBDMSION /1 ELMORE SUBOMSION /1 LOT 2. BLOCK 4 LOT 3, BLOCK 4 LOT 4, BLOCK 4 1 O I 1 I 11 jI / PROPOSED SEPOC PAGE 2 m I / F UPGRADE. SEE OF 2 FOR DETAILS. \ _ — — 1 1 ELMORE SUBDMSION /1 ELMORE SUBDMSION j1 \ 1 LOT 7, BLOCK 4 LOT S. BLOCK 4 \\ WONG SEPTIC THT_H_- ELMORE SUBDMSION /1 LOT S. BLOCK 6 I I I I I I I I RJAMNA ACRES SUBDMSION I TRACT 9 I I I � I I I ,I -- — — -- — — — — -- -- — ----- \ E. 142 AVE. I \ in 1 O I 1 I 11 jI / PROPOSED SEPOC PAGE 2 m I / F UPGRADE. SEE OF 2 FOR DETAILS. I �I 1 I I 1 I I ELMORE SUBDMSION /1 ELMORE SUBDMSION J1 i LOT 6, BLOCK 6 LOT 7, BLOCK 6 ---------- ----------- NA ALASKA `TATER & «'ASTLWNTLR I M.E.S/J W.M. `^^' K..m �.^ �.� „ • CONSU w wqm �InN�Cf907us74n9 • rex Po97L35eJ2461 = 1 OD, GARY do DIANA HAMMAN 345-6991 1 1 OF 2 ELMORE SUBDIVISION #11 LOT 5, BLOCK 4 OF WORK: SITE PLAN FOR DESIGN OF SEPTIC SYSTEM UPGRADE ILIAM A ACRES SUBDMSION TRACT 8 lfHJ-,n:e— ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DESARR ROAD. SUITE 76 • ANCHORAGE. AK 99504 ' PHONE (907)377-6179 • FAX (907)336-574 REPAIRED FOR: PHONE NUMBER: GARY do DIANA HAMMAN (907) 345-6991 EGA. DESCRIPTION: ELMORE SUBDIVISION #1; LOT 5, BLOCK 4 YPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE. 7/20/2001 AWN BY: B.S.G. ALL, 1"=30' GE NUMBER: 2 OF 2 4. Gamess: •7953 1 \ �1 U=- THE CONTRACTOR MUST HAVE THE SOUTH PROPERTY LINE FLAGGED BY A REGISTERED LAND LAJ SURVEYOR PRIOR TO ANY CONSTRUCTION. I =I I 1 m I \ E)LISTING FOUR BEDROOM HOUSE' I \ I / I / \�\ INSTALL DOUBLE EXISTING 1250 I �001 CLEANOUTS _ GALLON SEPTIC x F.C.O TANK. INSTALLED I I IN 1998.110, C PROPOSED 500 GALLON UFT / STATION. TM12 I O MH MfL°----------� I MTr---TMtt------ EXISTING DRAINFIELD�\\ PROPOSED PRESSURIZED ywNFlELDS. EXCAVATE TO BE COMPLETELY TWO TRENCHES THAT ARE FEET DEEP BY 5 FEET ABANDONED. �� WIDE BY 50 FEET LONG EACH (100 FEET LONG I \� TOTAL). ADD 0.5 FEET OF CLEAN, WASHED SEWER WILL CONSIST OF DRAIN ROCK. DISTRIBUTION LINE NATRONA AVENUE — — — — — ` 1.25' PVC WITH 1/4' HOLES EVERY 3' FEET. — INSTALL-TRENDH PMMIEL-70-5-- f:OMOU ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DESARR ROAD. SUITE 76 • ANCHORAGE. AK 99504 ' PHONE (907)377-6179 • FAX (907)336-574 REPAIRED FOR: PHONE NUMBER: GARY do DIANA HAMMAN (907) 345-6991 EGA. DESCRIPTION: ELMORE SUBDIVISION #1; LOT 5, BLOCK 4 YPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE. 7/20/2001 AWN BY: B.S.G. ALL, 1"=30' GE NUMBER: 2 OF 2 4. Gamess: •7953 ALASKA WATER & WASTE WATER CONSULTANTS, INC. 90I 8 M 99504 • 90 -61 9 • 90 " • WEBSMok-•a.eem SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: ELMORE /1 LOT 5, BLOCK 4 PERFORMED FOR: CARVY HAMMAN DATE: 6/22/01 (f ° ORGANICS ITEST HOLE #11 1 2 - SOIL GM 'y:ro`. CLASSIFICATIONS ORG GW = 7 - ,a: t GP ML 9:44 10 °°o o° 3 1/2- 8 °e°°° - 6- GM CL 9:54 °°' °opO 2 1/2. GC OL 4 0.0 ON 0% - 6 0o•p•90 °°p °•o° 10 SW MH 10:06 0. '• •0 °• SP CH 5 11 2 3/4- 3 1/4- 9 10:16 - 12 SM i OH 10:26 °°o 2 3/40 Sc 11 6 o°o° 6- GM 13 10:36 °oe pe°p 2 3/4- 3 1/4- DEPTH TO DATE GROUNDWATER 11.0' 6/22/01 10.0' 7/2/2001 I \ m iC y�i THA ' NATRONA AVE. \\\ �r--------- [\ S , -E LA DATE READING CLOCK TIME SW WATER LEVEL READING O°Op 6/25/01 1 7 - 6' - °o 0°e p° ° 9:44 10 °°o o° 3 1/2- 8 °e°°° - 6- 0 00 o° 4 9:54 °°o 2 1/2. 9 o°o' 9:55 0.0 ON 0% - 6 0o•p•90 10 10 °0 °°O° 7 10:06 °O•p•p0 °c o°o° 6- - 8 10:16 11 2 3/4- 3 1/4- 9 10:16 - 12 - 10 10:26 10 2 3/40 4 1/4' 11 10:26 6- GM 13 10:36 10 2 3/4- 3 1/4- 14- B.0.1L 15— 61718 16- 17- 18 19 20 COMMENTS: DEPTH TO DATE GROUNDWATER 11.0' 6/22/01 10.0' 7/2/2001 I \ m iC y�i THA ' NATRONA AVE. \\\ �r--------- [\ S , -E LA DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 6/25/01 1 9:34 - 6' - 2 9:44 10 2 1/2- 3 1/2- 3 9:44 - 6- - 4 9:54 10 2 1/2. 3 1/2- 5 9:55 6- - 6 10:05 10 2 5/8- 3 3/8- 7 10:06 - 6- - 8 10:16 10 2 3/4- 3 1/4- 9 10:16 - 6- - 10 10:26 10 2 3/40 4 1/4' 11 10:26 6- - 12 10:36 10 2 3/4- 3 1/4- PERCOLATION RATE 3.1 (MIN./INCH) PERC. HOLE DIA. 6- (INCHES) TEST RUN BETWEEN 5.0 FT. AND 6.0 FT. PERFORMED BY ALASKA WATER & WASTEWATER I, JEFFREY A. GARNESS, CERTIFY THAT THIS IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ALASKA WATER & WASTEWATER CONSULTANTS, INC. IJUIL LUG — rLKk VL-AllVN Mall LEGAL DESCRIPTION: ELMORE /1 LOT 5, BLOCK 4 PERFORMED FOR: GARY HAMMAN DATE, 6/22/01 (feet)TEST HOLE 2 1 ORGANICS 7 -101051;" SW SOIL CLASSIFICATIONS 1111°°° 1,111°° 7/2/2001 2 10°01 6" 6 °° 0000° 2 9:38 00 �e0o \ 4 5/8 °° V o; GW 000 -- ORG 0000 �>00 4 9:49 GM 1 1/2. 0 10- 5 1 I 0, — • 1 10:00 10 GP 4 1/2 I ML 3 — SRE PLAN — GM 13 1'd100' 1 5/8- C ° ° 10:11 B.O.H. I GM 10 CL 10 00 °010 16- 11 17- , 18- — 19 10 1 5/8" GC OL 4 1111 _ ° ° O°° O SW MH O °°° ° o 0° ° •�• SP CH 5 0°0 °oa °> SM ' ' : OH °°o °e1 SC0p 6 1111 00 o1v o0 7 -101051;" SW 6/22/01 1111°°° 1,111°° 7/2/2001 K\\ 10°01 6" 6 °° 0000° 2 9:38 00 �e0o \ 4 5/8 °° 3 9 000 6" — 0000 �>00 4 9:49 o•oo 1 1/2. 0 10- 5 1 I 0, — • 1 10:00 10 1 1/2" 4 1/2 \ \\\ 7 12— 12 — SRE PLAN — GM 13 1'd100' 1 5/8- C i li 10:11 B.O.H. 6" 14- 41516171819 10 15- 10 1 5/8" 16- 11 17- , 18- — 12 19 10 1 5/8" 20 COMMENTS: _ DEPTH TO GROUNDWATER DATE 10.5' 6/22/01 11.25' 7/2/2001 K\\ — 6" — DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING �\ 6/28/01 1 K\\ — 6" — 2 9:38 10 \ 4 5/8 3 9:39 — 6" — 4 9:49 10 1 1/2. 4 1/2 5 1 I 0, — • 1 10:00 10 1 1/2" 4 1/2 \ \\\ 7 j m' — SRE PLAN — 8 10:10 1'd100' 1 5/8- C i li 10:11 — 6" — 10 10:21 10 1 5/8" 4 3/8 11 TMtl , -- — 12 10:31 10 1 5/8" 4 3/8 NATRDNA AVE. DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 6/28/01 1 9:28 — 6" — 2 9:38 10 1 3/8- 4 5/8 3 9:39 — 6" — 4 9:49 10 1 1/2. 4 1/2 5 9:50 6" — 6 10:00 10 1 1/2" 4 1/2 7 10:00 — 6" — 8 10:10 10 1 5/8- 4 3/8 9 10:11 — 6" — 10 10:21 10 1 5/8" 4 3/8 11 10:21 6" — 12 10:31 10 1 5/8" 4 3/8 PERCOLATION RATE 2.3 (MIN.ANCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN 5.0 FT, AND 6.0 FT. PERFORMED BY ALASKA WATER k WASTEWATER I, JEFFREY A. GARNESS, CERTIFY THAT THIS IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: ,I U .. �, i C« ME t« .s ..tn . ar r w � _ 4 ' .f ��.: Ili�J•d,iju'ti-�i'j ry- 77- rga� _ + I �d�'Tirne-y ifrgIrTND3 rA ; MF S ail L•Ti� s3.ld k I t,:i �7�7i,��L•M�i,7�i:+� �.��'it�lk:?ii1F.�i�jZWaiCT�CS+��tT� t�(C • •'.ad'�r(��:1F3i1'iF1�.�'1ix•I+=i�1iT,rit?Eilats,�•1-tl ++� � , '. s^, f : . i • i • 4�'li1.C1 �1.1�1 t - i • 5§ 1.41 : i 'i iS .;�LE�I!M 11 • 1!W.��4= - I �i-ae (J'F�'�. Ik T� - a Fill —,a, 10 ni [•I�� J 7Ji1�•+rC?AUT:1i� Pt1J WIT�),IV 5Ta—C,;' ac-) :�� 'R••t11C�r=k,i�E�ifiry .t •'ice• ' y,�M �:rJ'.�1:4A:"�.'.11'a'.L'Y`S�'�! �a 111:1111 - i • tyt\S . _ :: � _ ' d T 1'1'�H-�� • c�ii rrc • • c w e Ik1iC.E7:3!alU, 1-: a. to=t •I i�li iCirj _ _ Ik:�.-i.l.tix'.'ll��l.��'I��'-i•�-.TA:.i.At�Y`Frr. � . is . I_ C •� r. �� I�'-r•1''C�j'�'j'L'.+::itlu,.'moi-•`�ja:�'i'�e".�{'��}' I(�l'14.1 � i.lr:'I .!l1SrYl'.�'lr��i��iYl r I � , r:rrlrrir�ryrx�nrr.�rrrr�r�. r , ►� s!Yi1i3CJi�G�i�tCl1�}, ��f^'7t_fii•l T'I�f.i> f u iii�1��l�tat�i lc^11�� GSii..1r?� � ��F Ifsl!nlCr.�ll�if1kp17�t�,1;+;lA�tj� "r G•"�u,af �-�,► ..-�!� yY r•+^ i'li lJl _ � /.jpllrla �, y` 11jy1�� it a. ��~�'��i��r`(,�?F.�t�:iE�I�EI%1�t►: • r ::TAT%��37 • c�'fii'. Ise -� L r"I Municipality of Anchorage Page of L_ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S1J9 902,3 f4 PID Number: 01%7— 171 — !0 Name: Wastewater System: ❑ New ❑ Upgrade Andress: P. _ 13 -ox ABSORPTION FIELD Phone: C :3.4.9--6991 - No. of 6 drooms: O Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: GPD/Sm 'rt. Lot: Block: Subdivision: / 5 4CY Depth to pipe bottom from original grade: Gravel depth beneath pipe FL Ft. Township: Range: Section: Fill added above original grade: Gravel length: WELL: ❑ New ❑ Upgrade Gravel width: Numberoflines: Disnncebetweea lines: Ft. Ft. Classification (Private, A,B,CI: Total Depth: Cased To: I Total absorption area: Pipe material: Ft. Ft. SC. Ft. Driller: Date Drilled: Static Water Level: Installer: ,J 1nJOOD �an� Date installed: Ft. a!- Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES XSeptic :3 Holding ❑S.T.E.P. To Septic Absorplion Litt Holding PubflVPrirate Manufacturer. Capacity in gallons: From Tank PieIC Sla:i//on Tank Sewer/Lines — -'�� t 1 AS L,i Welh 117171 WA A)//k Material: Number of Compartments: Surface ^1IA j LIFT STATION Water i Lot S 9.0 \ Size in gallons: Manufacturer. Line Foundation12.0 1 / j % "Pump on" level at: "Pump off' level at: High water alarm at: Curtain ^1/A f / I Pump Make &Model Electrical Inspections performed by: Drain Remarks: BENCH MARK Location and Description: �7 t� P GJ LAS' S �E�_ 170P ciC n C L.O C.. O S�1 G• Sf,J AAJ t>^ AY'q e Assumed Elevation: ENGINEER'S SEAL _ 0 4( ®PSE.,,: +S,aya S. 63tA��cK11�Dates: 1l,� Inspections performed by: � ls �,..• �� 7 2nd.�/1 p ... Department of Health and Human Services approval Aa°c°'., "° ` "0' Reviewed and approved bye Date: A'A I 72-013 (Rev. 9/91) MOA 25 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 15, 1998 Expiration Date: Jul 15, 1999 Permit Number: SW980234 Parcel ID: 018-171-40 Legal Description: ELMORE #1 BLK 4 LT 5 Design Engineer: A & L DRILLING COMPANY Site Address: 004941 NATRONA AVE Owner Name: Gary L. Hamman Lot Size: 23783 SQ. FT. Owner Address: PO BOX 230294 Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99523-0294 This permit is for the construction of: ❑ Disposal Field ❑,/ Septic Tank Holding Tank 0 Privy ❑ Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. An engineer must be on site for inspections during tank installation Received By: Issued By: Date: % l6` �n Date: 7 �5' 9Ge MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program \V" 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jul 15, 1998 Expiration Date: Jul 15, 1999 Permit Number: SW980234 Parcel ID: 018-171-40 Legal Description: ELMORE #1 BLK 4 LT 5 Design Engineer: A & L DRILLING COMPANY Site Address: 004941 NATRONA AVE Owner Name: Gary L. Hamman Lot Size: 23783 SQ. FT. Owner Address: PO BOX 230294 Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99523-0294 This permit is for the construction of: ❑ Disposal Field ❑,/ Septic Tank Holding Tank 0 Privy ❑ Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. An engineer must be on site for inspections during tank installation Received By: Issued By: Date: % l6` �n Date: 7 �5' 9Ge July 15, 1998 Municipality of Anchorage Department of Health & Human Services Environmental Services Division P.O. Box 196650 825 L Street, Suite 502 Anchorage, AK 99519-6650 (907) 343-4744 it/ Re: Lot 5, Block 4, Elmore Subdivision Addition #2 - To whom it may concern: The only work to be performed on the subject property is the removal and replacement of a damaged 1,250 -gallon septic tank. The existing tank is made of fiberglass, and cannot be made serviceable again. The replacement tank will have the same 1,250 -gallon capacity, and be installed in the same location as the existing tank. As there will be no change in the configuration or capacity of the system, there is no impact anticipated to any of the adjacent properties. Gary L. man Property ner -tL#/ aoa Low' �, t _ r• F ar F`. i., tls'. t�°v r- OF CR ENGINEERING GROUP SHEET- "t DA W m�G ev^cv� DATE l I�J`2e 3900 Arctic Blvd. •Suite 203-�"`�`�' Anchorage, Alaska 99503 CHECKED BY DATE SII IQ n 1:1 r•._O i S ;-!R V EY UE ii i 4It: •.CXiI -0 N' G Iron Pipe I — - - - o Me! Ain r i1...;Uf,?^y8 ic'Ci.rifi�i NC,lfli;y :.;_ r:� f �.••. ` ..4 F..' �_ --.,��..a..,.�.,�.�.y�..............�......a�,�....a.,.., ...M.,.....,. I ___ .._- r ,>,. _ -,cis ... .. -A '�- NOND — — e ie k% J "_ f 1 Iy .� S 1, I "i F` 1 qq '1 less 70:2 s*1015,70 Ffe�><acscs%xanSoto,.. 3 �pnor of the bnL L _ ., uc.Llon, tc R Ix anii t c <onilrC . C S anC ofdo r.:enis.' co::�nanis, e: estrictic+r_� wh::-is recxjrci�'d won p 1 1 1 1 Li� r j 1 rr ..lei r•._O i S ;-!R V EY UE ii i 4It: •.CXiI -0 N' G Iron Pipe I — - - - o Me! Ain r i1...;Uf,?^y8 ic'Ci.rifi�i NC,lfli;y :.;_ r:� f �.••. ` ..4 F..' �_ --.,��..a..,.�.,�.�.y�..............�......a�,�....a.,.., ...M.,.....,. I ___ .._- r ,>,. _ -,cis ... .. -A '�- NOND — — J f 6 qq '1 less 70:2 s*1015,70 Ffe�><acscs%xanSoto,.. 3 R Ix r•._O i S ;-!R V EY UE ii i 4It: •.CXiI -0 N' G Iron Pipe I — - - - o Me! Ain r i1...;Uf,?^y8 ic'Ci.rifi�i NC,lfli;y :.;_ r:� f �.••. ` ..4 F..' �_ --.,��..a..,.�.,�.�.y�..............�......a�,�....a.,.., ...M.,.....,. I ___ .._- r ,>,. _ -,cis ... .. -A '�- NOND — — 5. STATEMENT OF INSPECTIONBY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-sitewater supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. l further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation: t' s, Name of Firm" GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date P Z3 Engineer's Comments: In conducting this evaluation, GEG provided an engineering evaluation ofthe well andlorsemic system in accordance with the ' guidelines andregulations esfablishedbythe Municipaffy orAnchordge and moluslryprectioes. The reported results describe the . A�� OF ��+♦.♦♦ condition of the syshuWs on the dafels of The evaluation. Separation distances were messuredto maddyldentifiable feahoes. Hidden defects orencroachments may exist that were not identified during the evaluation The operafronalbfe ofall welsandseptic •'` systems depend on a vanely ofVanables including but Trot limited to sad conditions, groundwaterlevels(that may ftuate during the: year), quality of conssmchon(materials and workmanship)end the waferusage ofthe /amdy ohlzng the sysleMs-These ri ••fit' -x mQ *�1. - systerN& therefore, GEG makes no waventy (express or implled) regarding the Nture pedomwrrce of the well orseplic system.- 0 GEG makes no representation whether an aftemalin nY orseplic systemonbe installed on the property in the: event either olihe. j current systems fail. The content of this report is for the sole benefit of thepersonfpady who retained GEG. Reliance upon the �. �•. rey ••. �rnaasQ information provided in this report by any otherperson orparty including but not knifed to subsequent pmpertypurchasers, isnot • Gar r, authodad. In short, GER disavows any legal duly to anyone other than thepersoNpany who paid for this report.- - I��fT� �iEj-�3 _A, 6: DSD SIGNATURE 44000 FE ImIL System #1 Approved for bedrooms. System #2 Approved for bedrooms. . Disapproved: Conditional approval for bedrooms, with the following stipulations:SOFIf gN`' o�QP cyo�r ON-SITE VOTER AND lis WASTEWATER t PROGRAM BOriginal Certificate Date: Y: The -Municipality or Anchorage Develop,emfServices Division (DSD) issues Certificates of On -Site SystemsApproval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska The Municipality ofAnchorage .is not responsible for errors or omissions in the professional engineers work:. 7. ATTCHMENTS: COSA Checklist V Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 1011912) , _ _ If more than 1 septic system is on the lot: COSA Checklist # —Of— Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: ELMORE #1; BLOCK 4, LOT 5 Parcel ID: 018-171-40 A. WELL DATA *PER GEG INSPECTION **BASED UPON SURROUNDING WELLS Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed UNK Sanitary seal (YIN) YES Total depth *91.6+ft. Cased to **40+ ft. FROM WELL LOG Date of test UNK Static water level UNK ft, Well production UNK g.p.m. WATER SAMPLE RESULTS: Coliform NO colonies/100 ml. Nitrate 0.493 mg./L. Well Log (Y/N) M NO Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 7/16/2015 Arsenic: ND ug./L. Date of sample:1 1 /41201 5 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL (S.T.E.P.) Tank size 1250 gal. Number of Compartments 2 76.7 ft. 3+ g.p.m. Collected by: GEG. Ltd. Date installed 7/1998 Cleanouts(Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) YES Date of pumping 11/16/15 Pumper A+ HOME SERVICES C. ABSORPTION FIELD DATA BELOW EXISTING GRADE Date installed 7/25-26/2001 Soil rating .p.d./ r ft'/bdrm) 1_2 System type SHALLOW TRENCH Length 100 ft. Width 5 ft. Gravel below pipe 0.5 ft. Total depth *3.8+ ft. Eff. absorption area 500 ft' Monitoring tube YES Depression over field NO Date of adequacy test 7/16/2015 Results (Pass/Fail) **PASS For 4 bedrooms Fluid depth imabsorption field before test 0 in. Water added 659 gal. New depth Ein. Elapsed Time: 0 min. Final fluid depth . 0 in. Absorption rate >= 600+ g.p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date - **TESTED SOUTH TRENCH ONLY; NORTH TRENCH STAYED DRY THROUGHOUT TEST. SOIL COVER IN AREA OF MT4 IS ABOUT 2.5" SHY ON COVER. **PER 2001 INSPECTION REPORT. *PER 7/27/01 MOA ELECTRICAL INSPECTION REPORT FLOAT IS AT 41". APPROX 2" TETHER D. LIFT STATION Date installed 7/25-26/2001 Size in gallons 500 Manhole/Access (Y/N) YES "Pump on" level at s*43 in. "Pump ofr' level at **39 in. High water alarm level at **47 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? *YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: —,Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 75'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+i44 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main t o'+ Water service line t o'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: f Property line 10'+ Building foundation 10'+ Water main 10 Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION i certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date II l Id es - (Rev. 11105) OF aa _..w��l S •-N LYJT3 N89046'30"E, 133.39 Lora 10' UTIL. ESMT. ~ 1.6 OH l 05 � f Deck O 0 O O z ;S Chain Link I Fence SCALE: 1"= 30' LOT 0 M tvp•) 1 Story Frame i House 12.0 Shed o L_ 0 Leptic Vents Well 0 LOT 5 e N89046'30"E 133.70 NATRONA AVE. ��NXXX \ 1 OF ,,qL�+�, s �,9Q.49th00 ".z'S. Y:."... :.... ! i 1h,.Fred Wal atka: jos " 3255 - S 'k, AW EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB15-15, p. 2 CB 30 30 0 m AS -BUILT NO CORNERS SET THIS DATE I hereby certifydescribthatthat I have. performed a Mortgagee's inspection of the ELMORE SUB D. ADDeN pra dy:LOT S, BLOCK 4, Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 61h day of NOVEMBER 2015. FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) c6 W C? N L� •— LLi _ �LLII O LL LL n m o fL4-1 t 30 0 m AS -BUILT NO CORNERS SET THIS DATE I hereby certifydescribthatthat I have. performed a Mortgagee's inspection of the ELMORE SUB D. ADDeN pra dy:LOT S, BLOCK 4, Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 61h day of NOVEMBER 2015. FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) Municipality of Anchorage Development Services Department \ Building Safety Division OnSfte Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.akus (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parol I.D. 018-171-40 HAA# 4 L'16' G"11 tt 1. GENERAL INFORMATION Expiration Date: O / Complete legal description ELMORE SUBDIVISION #11: LOT 5. BLOCK 4. W ❑ CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parol I.D. 018-171-40 HAA# 4 L'16' G"11 tt 1. GENERAL INFORMATION Expiration Date: O / Complete legal description ELMORE SUBDIVISION #11: LOT 5. BLOCK 4. Community Class Well ❑ Public Water System Location (site address or directions) 14200 BUFFALO STREET " ANCHORAGE. AK 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address GARY HAMMAN Day phone 345-6991 P.O. BOX 230294 * ANCHORAGE. AK 99523 Day phone DAVE BROCK w/ PRUDENTIAL VISTA Day phone 4241 "B" STREET . ANCHORAGE, AK 99503 Unless otherwise requested, NAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ 562-6464 TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. J� Note: Alaska Water and Wastewater Consultants, Inc. shalt be paid S l == at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authotiryaoproval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system islare) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage tiles and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system isiare) in compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE. AK 99504 Engineer's Printed Name JEFFREY A. GARNESS. P.E. Engineer's Comments: in conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MCA DSD Guidelines Q Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory lest results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWwC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorfzed, nor will it confer any legal right whatsoever. Phone 337-6179 Date ./ 5. DSD SIGNATURE �,i ' Qi- AlttC sir �r ,....,.• ,s0 Approved for _ bedrooms. ON-SITE • • =� Disapproved. WATER AND ' Conditional approval for bedrooms, with the fllowing stipulations: ; WASTEWATER ORAV Attachments: HAA Checklist Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other Original Certificate Date: g ' % "0 / (R... 12M) Municipality of Anchorage • Development Services Department Sueding Safety Division J *.- On -Site Water b Wastewater Progrem 4700 South Bragew SL P.O. Banc 198850 Anchorage. AK 99519-850 www.ctandrorage.akus (907)943-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ELMORE S/D #t: LOT 5. BLOCK 4. Parcel ID: 018-171-40 A. WELL DATA Wen type PRIVATE HA, B, or C provide PWSID# N A Date completed UNK Sanitary seal (Y/N) Ya Total depth _12_+_f L Cased to 40+ fL FROM WELL LAG Date of test UNKNOWN Stafic Water level UNKNOWN IL Well production UNKNOWN O.P.M. WATER SAMPLE RESULTS: Well Log (YIN) NO Wires properly protected (YIN) YES Casing height (above ground) 12+ In, AT INSPECTION 6/18/01 81 fL 3.63 g.p.m. Conform colonles/100 mL N trateQa*mgJL. Other bacteriacolonles/100 ml. Date of sample: 01 Collected by: AWWC. INC. B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 1998 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A Date of pumpiig Z 51 aaii Pumper A+ Ac"Scrow-,eg C3I i•].��il•I:I2I#110I6Iitr Date installed 7/25-25/01 Son rating.p.d WUrn) 1_2 System type TRENCH Length too fL Wldlh 5 fL Gravel below pipe 0.5 fL Total depth '43-5.1 fL Eff. absorption area 500 ft' Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fan) For bedrooms Fluid depth in absorption field before test _ In. Water added _gal. New depth _in. Elapsed Time: _ min. Final fluid depth _ In. Absorption rete "-g.p.d. Arry rejuvenation treatment (past 12 mo.) (YIN 6 type) If yes, give date D. LIFT STATION Date installed 7/25-26/01 Size In gallons 500 Manhole/Access (YIN) YES "Pump on" level at 41 in. 'Pump ofr level at Win. High water alar level at 47 In. Datum BOTTOM OF TANK Cycles tested NEW Meets alar 6 circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankNft station on lot 100'+ Absorption laid on lot 100'+ Public sewer main N/A Sewer /septic service One 25'+ On adjacent lots 100'+ On adjacent lots 1 oo'+ Public sewer manhole/deanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC(HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 50+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10,+ Building foundation 10'+ Water main N/A Water service One 10'+ Surface water 100'+ Driveway, parldngArehide storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through tied Inspections and - .,p review of Munldpat records Nat the above systems are In ' ...... ' .. "' "" cordbnnance with MOA HAA guldellnes /n elfed on Nis date. e am se;' Engineer's Printed Name JEFFREY A. GARNESS 7953 ` 4D...........F,o Data P,. -.6 HAA Fee S ACY!) m Waiver Fee $ Date of Payment 81 le 0( Receipt Number Fw. W00) Date of Payment Receipt Number AUC -03-01 19:28 FR011-CUE ENVIROMENTAL SRV EoCUE Environmental Services Inc. rrrrriri.�iirrrrrrr� CUE ReLN 1014787001 Client Nate AIC Water & Wastewater Consultants Inc. Project NsmeN! Lt 5 Elk 4 Elmore Nl Buffalo Client Sample 1D Lt 5 Sk 4 Elmore Nl BUffal0 Matrix Drinking Water Ordered Ry PWSID 0 Sample Remarks: 9075615301 T-130 P.02/03 F-723 Client PON Printed Date/Time Collected Date/Clme Received Date/pme Technical Directtor,� Released BAY 08/03/2001 16:32 07/30/2001 13:11 07/30/2001 15:00 Stephen C. Ede �,�' Allowable PRP Analysis Pammcw Results PQL Units Method limits Date Date Init Watera Department Nitrate -N 0.906 Microbiology Laboratory Total Coliform D 0.500 mg/L EPA 300.0 (<10) 07/30/01 SCL 0 col/100ml. SM1892220 (<1) 07/30/01 KAP